In South Africa, stroke is the second-leading cause of mortality and long-term disability (SA). A complex condition, stroke is controlled by both modifiable and immutable factors. The stroke predictors in SA, particularly the modifiable and non-modifiable ones, are poorly understood. The development of appropriate health initiatives and policies aiming at lowering the burden of stroke can benefit from the identification of stroke predictors using suitable statistical approaches.
According to the World Health Organization (WHO), a stroke is a disorder marked by the rapid onset of symptoms and signs consistent with a local brain lesion, symptoms lasting for more than 24 hours, or symptoms that result in death from an unknown cause other than a vascular origin. Stroke continues to be the second greatest cause of mortality and a major contributor to long-term disability. Despite the fact that stroke is increasingly affecting public health in Africa, little is known regarding its modifiable and non-modifiable predictors. Despite the knowledge that treating modifiable risk factors can prevent stroke, it continues to be one of the major global health issues. The first step in prevention is to identify and make people aware of the risk factors for stroke.
It continues to be one of the largest risks to global public health. The first step in prevention is to identify and make people aware of the risk factors for stroke. This study in South Africa used a quantile regression approach to identify and measure the impact of modifiable and non-modifiable predictors of stroke in order to close this knowledge gap (SA).
There are two types of stroke predictors: modifiable and non-modifiable. Modifiable predictors include things like hypertension, smoking, cholesterol, obesity, and diabetes, whereas non-modifiable predictors include things like age, gender, and race that cannot be changed. The majority of studies found the male gender, older ages, and the black race as non-modifiable predictors, while important modifiable predictors included hypertension, cholesterol, heart issues, smoking, obesity, and diabetes. However, in SA, the majority of research concentrated on modifiable predictors and found diabetes, hypertension, and cholesterol as important modifiable predictors. The prevalence and contribution of modifiable and non-modifiable stroke predictors in SA need to be understood and quantified.
More people are having strokes
A stroke affects 10 adults in South Africa on average every hour, while heart disease and stroke account for 225 of the country’s daily fatalities. During this month of stroke awareness, the Heart and Stroke Foundation of South Africa (HSFSA) issues a warning, reminding us of the significant burden that heart disease and strokes place on our population. Stroke Week is observed worldwide from October 28 to November 3, and October 29 is designated World Stroke Day by the HSFSA.
“We’d really like to take this opportunity to raise awareness about the risks associated with cardiovascular disease, high blood pressure and strokes among South Africans. Obesity is a major contributing factor to all of these medical conditions. It’s a huge burden that has a negative impact on society and the economy, although the good news is that it is preventable through healthier behavioral choices,” says Professor Pamela Naidoo, CEO of the Heart and Stroke Foundation.“The reality is that South Africans consume too much sugar, salt, bad fats, alcohol and tobacco and don’t get quality sleep and sufficient exercise. The choices we make may lead to obesity, diabetes and heart disease.”
Professor Naidoo shares a few cautionary statistics:
- One in three South African adults has hypertension (high blood pressure), which heightens the risk of strokes, heart attacks, heart failure and kidney disease.
- In South Africa, strokes and heart disease are responsible for one in six deaths, but about 80% of that can be prevented by healthy lifestyle choices.
- Sixty percent of women and 31% of men in South Africa are overweight or obese.
HSFSA is committed to reducing these figures as a partner of the National Department of Health through promoting policy and legal changes. HSFSA supports front-pack labeling, lowering salt, sugar, and “bad fats” in processed foods, quitting smoking, and promoting responsible drinking.
International data on high blood pressure, strokes and heart disease
According to data from HSFSA, non-communicable diseases, such as chronic respiratory diseases, cancer, heart attacks, strokes, and diabetes, are the main cause of death worldwide. According to the data, non-communicable diseases cause more than 60% of all fatalities worldwide, with developing nations accounting for 80% of these deaths. These will outnumber all other causes of death in Africa by 2030. According to estimates, heart disease-related disorders account for 17.7 million deaths yearly, while high blood pressure is thought to be a factor in 12.8% of all fatalities worldwide.However, it is believed that 43-50% of women and 48-55% of males over 25 in sub-Saharan Africa have hypertension. Uncontrolled hypertension now affects a billion individuals worldwide, up from 600 million in 1980.
“Increased urbanization, stress and unhealthy behaviors contribute to hypertension. Structural inequality also impacts low-income people’s access to healthy unprocessed food, safe exercise and quality medical care,” says Professor Naidoo.
Director of the SA MRC Centre for Health Economics and Decision Sciences/PRICELESS at WITS University School of Public Health, Professor Karen Hofman, believes these systemic health issues call for high-level interventions. “Beyond regulation and taxation, we also need better food labelling, a curb on advertising unhealthy foods to children and strategies to make the healthy choice the easy choice for consumers.” Consumers may start by making smarter purchases by keeping an eye out for the Heart and Stroke Foundation’s signature red and white heart emblem on more than 450 consumer goods in South Africa, which offers advice on making healthy eating choices based on science.
Spotting the risk of stroke
A clot or bleed interrupts the blood supply to a portion of the brain, which results in a stroke and the death of nearby brain tissue. It is possible for stroke victims to develop difficulties and impairments that limit their ability to move, communicate, think, and feel. “Knowing the signs of stroke is critical. Minutes can save lives, speech, mobility, and independence. If you spot face drooping, a weak arm, and speech difficulties, get the person to the hospital immediately, this is easily identified using the FAST acronym,” says Professor Naidoo.
For accurate and beneficial information about stroke risk factors, lifestyle changes, and how to receive the medical treatment they need, South Africans should also keep an eye out for the Heart and Stroke Foundation’s mobile clinics or visit their website. The World Stroke Organization asks the public to use their free tools, such as their online toolbox and stroke spotter game, on this World Stroke Day
What researchers say about stroke
Professor Karen Hofman, a research professor and the founding director of the South African Medical Research Council (SAMRC)/Wits Centre for Health Economics and Decision Science, believes that high-level interventions are necessary to address these systemic health problems.“Beyond regulation and taxation, we also need better food labelling, a curb on advertising unhealthy foods to children and strategies to make the healthy choice the easy choice for consumers,” she said.
She advised shoppers to seek the Heart and Stroke Foundation’s signature red and white heart emblem on more than 450 consumer goods in South Africa, which offers advice on making healthy food choices based on evidence.According to Hofman, South Africa spends between R30 and R50 billion annually on direct health costs. This relates to hospitalization, outpatient treatment, pharmaceutical, and rehabilitation costs associated with heart disease, diabetes, and high blood pressure.
She said obesity-related diseases were now more common than HIV in South Africa: “Cardiovascular disease, which leads to stroke, is the leading cause of premature death and disability in the non-communicable diseases cluster in South Africa. Obese individuals are at risk medically, but they are also losing out economically, due to lower productivity which leads to lower wages, and increased illness, disability, early retirement and premature mortality. Obesity is a severe and costly problem in SA, but the good news is that it is preventable and reversible.”
Says Naidoo Knowing the source of your obesity and treating it greatly reduces your risk of developing co-morbid conditions including cancer, diabetes, arthritis, heart disease, high blood pressure, and other diseases. According to Naidoo, hypertension, in turn, heightens the risk of stroke, ischaemic heart disease, renal insufficiency and dementia, “but thankfully it is readily treatable.”
Spotting the risk of stroke
- A stroke happens when the blood supply to a part of the brain is interrupted by a clot or a bleed which causes surrounding brain tissue to die.
- Stroke survivors can be left with disabilities and impairments that affect how they move, speak, think, and feel.
“Knowing the signs of stroke is critical. Minutes can save lives, speech, mobility, and independence. If you spot face drooping, a weak arm, and speech difficulties, get the person to the hospital immediately, this is easily identified using the FAST acronym,” said Naidoo. The FAST stands for Facial drooping, Arm weakness, Speech difficulties and Time.
Symptoms of Stroke
F – Face drooping
A – Arm weakness
S – Speech difficulty
T – Time to call emergency medical services
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